Since how long have you been suffering with this problem ?
WeeksMonthsYears
Which part of the body is affected ?
HandsLegsBoth
Has the fungus been spreading over time ?
YesNoMay be
Is there any discoloration of the nail ?
What is the colour of your nails ?
YellowBrownSome colour
Is there any pain in the affected nails ?
YesNoOccasionally
Are there any lines on the nails ?
Are your nails disfigured ? YesNoMay be
Is there a family history of a similar complaint ?
YesNoDon't know
Are you diabetic ?
YesNoNot Sure
Do you work a lot in the water ?
Attach a photograph of your affected nail. Have you got any investigation done? (If yes, then please mention the details of the reports in the 'more symptoms' column at the end of the questionnaire)
YesNoLater
Are you already a patient with Dr. Manoj's Homeopathy? If yes, then please give your Registration Number in the 'more symptoms' column.
YesNo
Name:
Email Address:
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Gender:MaleFemale
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More Symptoms:
